Trends in the consumption of opioid analgesics in Taiwan from 2002 to 2007: a population-based study.

CONTEXT: Morphine consumption is an important indicator of a country's progress in cancer pain relief. However, opioid prescription data are lacking for Taiwan.

OBJECTIVES: To investigate opioid consumption patterns in Taiwan, compare the results with those from selected countries, identify differences between patients with and without cancer, and determine the associated expenditure.

METHODS: Data on prescriptions for three so-called strong opioids (fentanyl, morphine, and pethidine [meperidine]) and one so-called weak opioid (codeine) were obtained from the Taiwan National Health Insurance Research Database for 2002-2007. The data were converted into a defined daily dose for statistical purposes per million inhabitants per day. Associated payments and diagnoses also were obtained from the database.

RESULTS: From 2002 to 2007, opioid consumption in Taiwan increased by 55% from 362 to 560 defined daily dose for statistical purposes per million inhabitants per day. This ranks Taiwan as 56th among 181 countries and areas according to the statistical data for 2005-2007 from the International Narcotics Control Board. Among the investigated opioids, prescriptions for transdermal fentanyl and oral morphine increased markedly from 2002 to 2007. Pethidine (meperidine) was predominantly prescribed to patients without cancer diagnoses (around 80%). The total expenditure on opioid prescriptions was US$10.2 million in 2007 for a population of 23 million.

CONCLUSION: Opioid prescriptions and expenditure increased steadily from 2002 to 2007 in Taiwan, as in nearby Asian countries, but remained much lower than in developed countries. Pethidine (meperidine) was predominantly prescribed to noncancer patients, whereas morphine and fentanyl were mainly prescribed for cancer patients.